1. Intravenous thrombolysis for ischemic stroke in the posterior circulation : a systematic review and meta-analysisRobrecht R. M. M. Knapen, Senta Frol, Sander M.J. van Kuijk, Janja Pretnar-Oblak, Christiaan van der Leij, Robert J. van Oostenbrugge, Wim H. van Zwam, 2024, izvirni znanstveni članek Ključne besede: Intravenous thrombolysis, ischemic stroke, posterior circulation
Objavljeno v DiRROS: 12.06.2026; Ogledov: 95; Prenosov: 223
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2. How much of the variance in functional outcome related to intracerebral hemorrhage volume is already apparent in neurological status at admission?Vincent Geest, Janja Pretnar-Oblak, Katarina Šurlan Popović, Jawed Nawabi, Sarah Elsayed, Constanze Friedrich, Maik Böhmer, Burak Akkurt, Peter Sporns, Andrea Morotti, Senta Frol, 2024, izvirni znanstveni članek Ključne besede: intracerebral hemorrhage, stroke, mediation analysis
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3. Acute ischemic stroke trends in Slovenia, 2015-2022 : declining admissions, rising reperfusion, uneven gainsTjaša Furlan, Borut Jug, Neža Nograšek, Dalibor Gavrić, Janja Pretnar-Oblak, Petra Došenović Bonča, Senta Frol, 2026, izvirni znanstveni članek Povzetek: ntroduction: We assessed nationwide trends in administratively identified ischaemic stroke admissions, pro- cedures, secondary prevention, and outcomes in Slovenia using linked national datasets in the absence of a dedicated stroke registry. Methods: We conducted a nationwide longitudinal analysis of adult hospital admissions captured in linked administrative databases between 2015 and 2022. We report crude index-admission rates, acute procedures (intravenous thrombolysis [IVT], mechanical thrombectomy [MT], carotid thromboendarterectomy [CEA], ca- rotid artery angioplasty with stenting [CAS]), discharge secondary-prevention prescriptions, and time-to-death analyses with a maximum follow-up of 5 years. Results: We included 16,839 unique index patients (median age 74 years; 54% male). Admissions peaked in 2017 (2169) and crude rates decreased from 105 to 99 per 100,000 residents by 2022. Revascularisation increased (IVT 6.2% to 15%, MT 5.4% to 9.5%, CEA 9.1% to 14%), length of stay decreased, and discharge prevention therapy improved. Five-year mortality was higher with age and comorbidity and lower among patients receiving IVT and several secondary-prevention therapies. Care pathways differed by stroke aetiology; women were older and men underwent more CAS and CEA, while IVT and MT were similar. Conclusion: Crude admissions declined modestly while reperfusion and prevention improved, but the magnitude and pattern of improvement differed by care domain and patient subgroup, supporting continued monitoring and the development of a national stroke registry.
Ključne besede: Slovenija, zdravje, bolezni, kap, zdravljenje, trendi
Objavljeno v DiRROS: 02.06.2026; Ogledov: 148; Prenosov: 62
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4. Revisiting antiplatelet therapy in acute carotid tandem lesionsMatija Zupan, Lara Straus, Pawel Kermer, Panagiotis Papanagiotou, Senta Frol, 2026, pregledni znanstveni članek Povzetek: Background/Objectives: Acute carotid tandem lesions (TLs), defined by concurrent cervical internal carotid artery (ICA) stenosis or occlusion and intracranial large vessel occlusion, occur in 10–20% of patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Optimal periprocedural antiplatelet management during emergent carotid artery stenting (eCAS) remains uncertain, particularly regarding the balance between preventing stent thrombosis and avoiding hemorrhagic complications. Methods: A narrative review was conducted using PubMed and Scopus (until 6 March 2026) to identify English-language studies evaluating antiplatelet therapies during eCAS for TLs. We included seven real-world studies and registry analyses. Data on study design, patient characteristics, procedural strategies, angiographic results, functional outcomes, and safety metrics were extracted. Results: No randomized controlled trials (RCTs) were identified. The available evidence is derived exclusively from observational studies. Across these cohorts, glycoprotein IIb/IIIa inhibitors (GPIs), particularly tirofiban, were generally associated with lower rates of in-stent thrombosis and higher reperfusion success, with symptomatic intracranial hemorrhage (sICH) rates that appeared comparable to or lower than those reported with acetylsalicylic acid (ASA). Cangrelor, an intravenous (IV) P2Y12 inhibitor, was associated with improved stent patency and increased likelihood of complete reperfusion, although reported effects on clinical outcomes were inconsistent when compared with GPIs or ASA. Aside from abciximab, potent IV antiplatelet agents did not consistently show an increased sICH signal. Oral dual antiplatelet therapy was also associated with improved technical outcomes without a clear excess in bleeding complications. Conclusions: Current real-world observational data suggest that rapid-acting IV antiplatelet agents—particularly GPIs and, increasingly, cangrelor—may represent feasible periprocedural options during eCAS for TLs, with potential benefits for technical success and no consistent evidence of increased hemorrhagic risk. However, interpretation is limited by study heterogeneity and non-randomized designs. The absence of RCTs highlights the need for prospective comparative studies and standardized periprocedural antiplatelet protocols.
Ključne besede: acute carotid tandem lesions, acute ischemic stroke, antiplatelet therapy, cangrelor, glycoprotein IIb/IIIa inhibitors
Objavljeno v DiRROS: 23.04.2026; Ogledov: 184; Prenosov: 122
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5. Selecting substitutes for cranial dural repair and preventing intracranial iatrogenic amyloid transmissionBruno Splavski, Senta Frol, 2025, pregledni znanstveni članek Povzetek: Dural repair following an osteoplastic craniotomy presents significant challenges, necessitating an optimal dural substitute to avoid complications and ensure successful patient outcomes when primary dural closure is not possible. Ideal substitutes provide a scaffold for fibroblast migration and implantation, which are essential for achieving postoperative dural sealing and watertightness. However, such a substitute seldom exists, underscoring the importance of choosing appropriate materials for dural repair to reduce the risks of postoperative complications, including iatrogenic prion contamination that may promote intracranial amyloid transmission. Available dural substitutes are categorized into autologous, allogeneic, and xenogeneic transplants, as well as organic, synthetic, and composite polymer grafts. While each category offers specific benefits, many disadvantages persist, including the risks of prion-like amyloid protein deposition, particularly spreading iatrogenic Creutzfeldt-Jakob disease. These risks have historically been associated with the use of cadaveric dura grafts and prion-contaminated surgical instruments, necessitating safer replacement materials and enhanced sterilization protocols. This narrative review addresses the critical challenges of dural repair following cranial surgery, proposing innovative directions that include the use of composite materials and emerging technologies, such as 3D printing. Through a narrative review, the evaluation of traditional and advanced dural substitutes is provided, summarizing the advantages and limitations of currently available dural substitutes. In conclusion, the ideal dural substitute should closely replicate the natural structure of the dura, support tissue regeneration, and prevent postoperative complications such as cerebrospinal fluid leakage and intracranial iatrogenic amyloid transmission, thereby ensuring optimal patient outcomes and recovery.
Ključne besede: cerebral amyloid angiopathy, cranial dural defect, dural substitutes, iatrogenic amyloid transmission, prevention of complications
Objavljeno v DiRROS: 22.04.2026; Ogledov: 220; Prenosov: 65
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7. Letter to the editor regarding "Safety of tenecteplase versus alteplase for intravenous thrombolysis in acute ischemic stroke patients with direct oral anticoagulation: experience from a German stroke center" by Mers et al.Matija Zupan, Pawel Kermer, Senta Frol, 2026, drugi znanstveni članki Ključne besede: intravenous thrombolysis, tenecteplase, alteplase, acute ischemic stroke, direct oral anticoagulant intake, DOAC
Objavljeno v DiRROS: 23.03.2026; Ogledov: 330; Prenosov: 178
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10. Cerebrospinal fluid β‐amyloid and τ levels in patients with iatrogenic cerebral amyloid angiopathy, sporadic cerebral amyloid angiopathy, Alzheimer disease, and controlsUlf Jensen-Kondering, Nils G. Margraf, Slaven Pikija, Kinga Rak-Frattner, Branko Malojcic, Senta Frol, Janja Pretnar-Oblak, Patricia De la Riva, Ines Albajar Gomez, Jacopo C. DiFrancesco, 2025, izvirni znanstveni članek Povzetek: Background: Iatrogenic cerebral amyloid angiopathy (iCAA) is a subform of cerebral amyloid angiopathy caused by exposure to amyloid β. The aim of this study was to assess cerebrospinal fluid amyloid and τ concentrations in iCAA in comparison with sporadic cerebral amyloid angiopathy (sCAA), Alzheimer disease (AD), and controls. Methods: We conducted a systematic literature review to identify patients with iCAA with published cerebrospinal fluid marker concentrations. We then analyzed the cerebrospinal fluid concentrations of amyloid β40, amyloid β42, total τ, and phosphorylated τ 181, comparing them with the corresponding data of patients with sCAA, AD, and controls from our previous work. Results: The study included 25 patients with iCAA (age, 44±11 years), 31 patients with sCAA (age, 75±5 years), 28 patients with AD (age, 71±8 years) and 30 controls (age, 72±8 years) from 9 case descriptions and 1 cohort study. Amyloid β40 concentrations did not differ significantly between iCAA and the other groups. Amyloid β42 concentration was significantly higher in controls than iCAA and the other groups. The amyloid β42/40 ratio was higher in iCAA than in AD and higher in controls than sCAA and AD. Total τ concentrations were lower in controls than iCAA but did not differ significantly between iCAA, sCAA, and AD. Phosphorylated τ concentrations were not significantly different in iCAA compared with controls, significantly higher in sCAA, and highest in AD. Conclusions: The observation that phosphorylated τ concentrations in iCAA are not different from controls led us to the hypothesis that iCAA is characterized by amyloid plaque formation largely without concomitant phosphorylated τ aggregation, which is well compatible with most published pathologic studies.
Ključne besede: phosphorylated τ, Alzheimer disease, amyloid β, amyloid β40, amyloid β42, cerebrospinal fluid, iatrogenic cerebral amyloid angiopathy
Objavljeno v DiRROS: 10.03.2026; Ogledov: 357; Prenosov: 259
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